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The primary purpose of this study is to compare the root coverage rate of the gingival unit-shaped connective tissue graft, obtained by intraoral de-epithelization, with the traditional de-epithelialized free gingival graft in localized recessions of anterior and premolar teeth. In addition, it is aimed to compare the postoperative gingival thickness between the two techniques. The secondary aim is to search the effects of both techniques on periodontal parameters and to evaluate patient-centered outcomes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| De-epithelialized gingival unit graft | Experimental | In this split-mouth randomized controlled trial, the coin toss method will determine test and control groups. In both groups, connective tissue graft with a trapezoidal flap design will be applied to the recession area. To obtain the connective tissue graft, the gingival unit graft will be de-epithelialized in the test group. |
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| De-epithelialized free gingival graft | Experimental | In this split-mouth randomized controlled trial, the coin toss method will determine test and control groups. In both groups, connective tissue graft with a trapezoidal flap design will be applied to the recession area. To obtain the connective tissue graft, the traditional free gingival graft will be de-epithelialized in the control group. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Coronally advanced flap with connective tissue graft | Procedure | In both groups, connective tissue graft with a trapezoidal flap design will be applied to the recession area. |
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| Measure | Description | Time Frame |
|---|---|---|
| Root coverage percentage | The comparison of the postoperative recession depth to the initial recession depth | Postoperative 6th month |
| Gingival thickness | Gingival thickness in the mid-buccal of the recession defect measured with an endodontic spreader and digital recordings | Preoperative and postoperative 6th month |
| Measure | Description | Time Frame |
|---|---|---|
| Recession width | Recession width measured at the cemento-enamel junction | Preoperative and postoperative 6th month |
| Probing depth | Probing depth measured at the mid-buccal of the recession defect |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kutahya Health Sciences University | Kütahya | 43020 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 12636127 | Background | Kassab MM, Cohen RE. The etiology and prevalence of gingival recession. J Am Dent Assoc. 2003 Feb;134(2):220-5. doi: 10.14219/jada.archive.2003.0137. | |
| 26941519 | Background | Mythri S, Arunkumar SM, Hegde S, Rajesh SK, Munaz M, Ashwin D. Etiology and occurrence of gingival recession - An epidemiological study. J Indian Soc Periodontol. 2015 Nov-Dec;19(6):671-5. doi: 10.4103/0972-124X.156881. |
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| ID | Term |
|---|---|
| D005889 | Gingival Recession |
| D003807 | Dentin Sensitivity |
| D017622 | Periodontal Attachment Loss |
| ID | Term |
|---|---|
| D005882 | Gingival Diseases |
| D010510 | Periodontal Diseases |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
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| Preoperative and postoperative 6th month |
| Clinical attachment loss | Clinical attachment loss measured at the mid-buccal of the recession defect | Preoperative and postoperative 6th month |
| Keratinized gingiva width | Mid-buccal gingival width measured with a periodontal probe | Preoperative and postoperative 6th month |
| Vestibular depth | The distance from the gingival margin to the greatest concavity of the mucosal fold | Preoperative and postoperative 6th month |
| Pain perception | Visual analog scale where higher scores mean a worse outcome and has a minimum value of 0 and a maximum value of 10 | Postoperative 1st week |
| Bleeding related to the procedure | Bleeding evaluated by a dichotomous index | Postoperative 1st week |
| 20103476 | Background | Kassab MM, Badawi H, Dentino AR. Treatment of gingival recession. Dent Clin North Am. 2010 Jan;54(1):129-40. doi: 10.1016/j.cden.2009.08.009. |
| 27454460 | Background | Cairo F, Pagliaro U, Buti J, Baccini M, Graziani F, Tonelli P, Pagavino G, Tonetti MS. Root coverage procedures improve patient aesthetics. A systematic review and Bayesian network meta-analysis. J Clin Periodontol. 2016 Nov;43(11):965-975. doi: 10.1111/jcpe.12603. Epub 2016 Sep 16. |
| 31177536 | Background | Zucchelli G, Tavelli L, Barootchi S, Stefanini M, Rasperini G, Valles C, Nart J, Wang HL. The influence of tooth location on the outcomes of multiple adjacent gingival recessions treated with coronally advanced flap: A multicenter re-analysis study. J Periodontol. 2019 Nov;90(11):1244-1251. doi: 10.1002/JPER.18-0732. Epub 2019 Jul 1. |
| 15119887 | Background | Allen AL. Use of the gingival unit transfer in soft tissue grafting: report of three cases. Int J Periodontics Restorative Dent. 2004 Apr;24(2):165-75. |
| 22390550 | Background | Kuru B, Yildirim S. Treatment of localized gingival recessions using gingival unit grafts: a randomized controlled clinical trial. J Periodontol. 2013 Jan;84(1):41-50. doi: 10.1902/jop.2012.110685. Epub 2012 Mar 5. |
| 32233187 | Background | Sriwil M, Fakher MAA, Hasan K, Kasem T, Shwaiki T, Wassouf G. Comparison of Free Gingival Graft and Gingival Unit Graft for Treatment of Gingival Recession: A Randomized Controlled Trial. Int J Periodontics Restorative Dent. 2020 May/Jun;40(3):e103-e110. doi: 10.11607/prd.4180. |
| D055093 |
| Periodontal Atrophy |
| D014076 | Tooth Diseases |